2018-05-12T09:08:21-05:00 2017-06-30 990 2016-07-01 620347580 Saint Thomas West Hospital SAIN 3147338000 4220 Harding Rd Nashville TN 37205 Tonya Mershon Tax Officer 2017-10-25 2016 2021-01-29 14:40:06Z Karen Springer 4220 Harding Rd Nashville TN 37205 444339505 false 0928 X www.sths.com/west X 1898 TN To improve the health and well-being of all people in the communities we serve. 13 12 2249 227 0 -14209787 205286 366250 407021200 422925590 -4359 -103922 19865503 20200109 427087630 443388027 1679321 1331023 0 113840342 111469949 0 0 270208933 291030723 385728596 403831695 41359034 39556332 224457272 315474205 144282961 174583118 80174311 140891087 Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. false false 351805081 1331023 440056667 SAINT THOMAS WEST HOSPITAL PROVIDES A SUBSTANTIAL PORTION OF ITS SERVICES TO THE ELDERLY AND POOR. DURING THE FISCAL YEAR ENDING JUNE 30, 2017, 61.7% OF THE VALUE OF SERVICES RENDERED WAS TO ELDERLY PATIENTS UNDER THE MEDICARE PROGRAM, AND APPROXIMATELY 9.1% OF THE VALUE OF THE SERVICES WAS PROVIDED TO PATIENTS WHO WERE DEEMED INDIGENT UNDER STATE, COUNTY, OR SAINT THOMAS WEST HOSPITAL GUIDELINES. SEE SCHEDULE H FOR SUPPLEMENTAL INFORMATION ON COMMUNITY BENEFIT. 351805081 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 138 0 true 2249 true false false false false false false false false false false X 13 12 false false false false true true true true true false false false true true true true true false false true true X Lisa Davis 6152846826 4220 Harding Rd Nashville TN 37205 KAREN L SPRINGER BOARD MEMBER & PRESIDENT/CEO STHE 1.0 50.0 X X 0 1285320 20076 ANTHONY HEARD VICE-CHAIRMAN 1.0 10.0 X X 0 0 0 CLARK BAKER CHAIRMAN 1.0 10.0 X X 0 0 0 PATRICK R SHEPHERD SECRETARY 1.0 10.0 X X 0 0 0 LEE MOSS TREASURER 1.0 10.0 X X 0 0 0 WILLIAM ANDERSON BOARD MEMBER 1.0 10.0 X 0 0 0 SISTER HELEN BREWER DC BOARD MEMBER 1.0 10.0 X 0 0 0 DELL CROSSLIN BOARD MEMBER 1.0 10.0 X 0 0 0 EMIL HASSAN BOARD MEMBER 1.0 10.0 X 0 0 0 STEVE SCHWAB MD BOARD MEMBER 1.0 10.0 X 0 0 0 SCOTT STANDARD MD BOARD MEMBER 1.0 10.0 X 0 0 0 SUSAN WEST PhD BOARD MEMBER 1.0 10.0 X 0 0 0 BRIAN WILCOX MD BOARD MEMBER 1.0 10.0 X 0 0 0 SAMAR ALI BOARD MEMBER (END 12/2016) 1.0 10.0 X 0 0 0 PAMELA M HESS CFO STW/STM (END 7/2016) 20.0 20.0 X 160254 253185 36631 DON E KING CEO/PRESIDENT STW/STM 20.0 20.0 X 0 651378 39635 MARK MARSDEN MD CHIEF MEDICAL OFFICER 40.0 0 X 495116 0 36207 JENNIFER ELLIOTT CNO (END 12/2016) 20.0 20.0 X 0 297419 29337 CARRIE B TEAFORD COO STW/STM 20.0 20.0 X 368703 0 32444 MATTHEW JOSSEPH MD PHYSICIAN 40.0 0 X 419509 0 23292 KYRIAKOS KYRIAKIDIS MD PHYSICIAN 40.0 0 X 392078 0 40241 EUGENE F LAFRANCHISE MD PHYSICIAN 40.0 0 X 510442 0 42953 MICHAEL MEADORS MD PHYSICIAN 40.0 0 X 367074 0 35786 STEVEN TARQUINE MD PHYSICIAN 40.0 0 X 397312 0 37418 MICHAEL H SCHATZLEIN MD FORMER OFFICER (END 3/2016) 0.0 50.0 X 0 3128428 37373 ALAN STRAUSS FORMER OFFICER (END 4/2012) 0.0 0.0 X 0 624067 7919 BERNARD J SHERRY FORMER OFFICER (END 8/2015) 0.0 51.0 X 0 1559311 45520 3110488 7799108 464832 111 true true false CARDIOVASCULAR ANESTHESIOLOGISTS PC 4230 HARDING PIKE SUITE 435 NASHVILLE TN 372054900 MEDICAL SERVICES 3439284 TENNESSEE PERFUSION ASSOCIATES 649 SPRINGLAKE DR FRANKLIN TN 37064 MEDICAL SERVICES 2035755 DIALYSIS CLINIC INC 1600 HAYES STREET SUITE 100 NASHVILLE TN 372033018 DIALYSIS SERVICES 1277506 WHITAKER MEDICAL LLC 10375 RICHMOND AVE SUITE 1700 HOUSTON TX 77042 NURSE STAFFING SERVICES 1175008 ORTHO SURGICALISTS LLC 608 NORRIS AVE NASHVILLE MA 37204 MEDICAL SERVICES 500000 21 X 366250 366250 NET PATIENT SVCS REV 621990 419132369 419132369 INTERCOMPANY RENT 532000 38260 38260 NUCLEAR PHARMACY 621400 1396019 1396019 JOINT VENTURE INCOME 621400 2358942 2358942 0 0 0 0 422925590 34391 34391 1306396 810915 495481 0 495481 495481 2250 140563 0 -138313 -138313 -138313 PROVIDER TAX 621990 16043916 16043916 CAFETERIA/VENDING 722514 2573551 2573551 Wellness Center 621990 258277 258277 828884 828884 0 0 19704628 443388027 440056667 0 2965110 1331023 1331023 932470 839223 93247 93066369 83759733 9306636 -2376800 -2139120 -237680 13125264 11812738 1312526 6722646 6050381 672265 8213420 7392078 821342 0 25967 25967 1376471 1101177 275294 386454 367131 19323 5663161 5096845 566316 40438 32350 8088 136833 109467 27366 3295475 3130701 164774 18362377 16526139 1836238 2352344 2234727 117617 PURCHASED SERVICES 132336709 105869367 26467342 MEDICAL SUPPLIES 94416010 84974409 9441601 PROVIDER TAX 16043916 16043916 equipment rent 1983293 1784964 198329 6397855 5461865 935990 0 403831695 351805081 52026614 0 5867691 10303047 50711486 51998639 0 0 0 0 9447597 10122742 1634724 4774001 498736240 354735502 134695270 144000738 0 6657232 7260576 682698 502000 14760574 86512462 224457272 315474205 27489716 23651457 261312 307894 0 116531933 150623767 144282961 174583118 X 80174311 140891087 80174311 140891087 224457272 315474205 X 39556332 21160444 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 27495 27495 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to state hospital associations that are specifically allocable to lobbying. Saint Thomas West Hospital does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to state hospital associations that are specifically allocable to lobbying. Saint Thomas West Hospital does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 4505398 536929 689422 52997 5678752 5211371 112796 -327139 491630 4505398 5045861 15640 175024 25154 5211371 3727093 662526 757499 101257 5045861 3683758 42664 430651 429980 3727093 0.0 0.5493 0.4507 false true true 4458348 4458348 321028139 218788899 102239240 2022923 2022923 0 163058530 128415608 34642922 8168300 5508072 2660228 144000738 intercompany accounts receivable 82102608 prepaid pension receivables from third party payors 2063349 physician guarantee asset 1688872 other assets 252406 other receivables 41258 security deposit 349205 deferred compensation asset 14764 86512462 INTERCOMPANY PAYABLE 43245565 INTERCOMPANY DEBT TO ASCENSION HEALTH ALLIANCE 98289610 SELF INSURANCE LIABILITY 4159117 PHYSICIAN GUARANTEE 964769 AH SAVINGS PLAN LIABILITY 1186115 PAYABLE TO THIRD PARTY PAYORS 2628584 OTHER LIABILITIES 150007 150623767 X Schedule D, Part V, Line 4 Intended uses of endowment funds The endowment funds are held by Saint Thomas Health Foundations. The endowment funds are specifically designated pools of assets held and invested by the Foundation to provide long-term growth, interest and dividends. Only the income from an endowment fund is used. 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 12078745 12078745 0.0299 36628072 30232896 6395176 0.0158 0 0.0 0 0 48706817 30232896 18473921 0.0458 1417664 1279769 137895 0.0003 2275999 837278 1438721 0.0036 1918500 1846602 71898 0.0002 66384 66384 0.0002 1512016 1512016 0.0037 0 0 7190563 3963649 3226914 0.0080 0 0 55897380 34196545 21700835 0.0538 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 10255 10255 0.0000 0 0.0 1680 1680 0.0000 0 0.0 0 0 11935 0 11935 0.0000 true 17577623 3233670 145928656 152796638 -6867982 X true true 1 1 Saint Thomas West Hospital 4220 Harding Road Nashville TN 37205 www.sths.com/west 0000000024 X X X Saint Thomas West Hospital 1 false false true X X X X X X X X X 15 true true true true X http://www.sthealth.com/about-us/mission-integration/community-health/community-health-needs-assessm X true 16 true http://www.sthealth.com/about-us/mission-integration/community-health/community-health-needs-assessm false true X 250.0 400.0 X X true true X X X true X https://www.sthealth.com/patients-and-visitors/financial-assistance X https://www.sthealth.com/patients-and-visitors/financial-assistance X https://www.sthealth.com/patients-and-visitors/financial-assistance X X X X X true X X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Saint Thomas West Hospital. The CHNA process included input from those with special knowledge of or expertise in public health. The partnering organizations had representatives with experience and/or training in public health. Additionally, the local public health department participated during the design of the CHNA process and participated in the interviews and the community health summit. Throughout the CHNA process the partnering organizations also received input from those with special knowledge of or expertise in public health. Individual interviews and the Community Health Summit included community members with special knowledge and/or expertise in public health. All interviews, listening sessions, secondary data analysis, and community review of findings were conducted with the goal of obtaining an assessment of health needs and assets that not only represent the broad interests of Davidson County, Tennessee, but pays special attention to the underserved, low-income, minority and vulnerable populations. This lens of special attention to at-risk populations was then used in selection of interviewees, sites for community listening sessions, and attendees of the community health summit. Input from persons representing broad interests of the community and populations which are underserved, low-income, minority and/or with chronic disease needs were included through interviews of community representatives and leaders, community listening sessions, and a community health summit. While the partnering organizations collaborated with many community agencies and experts, consultants were not used during the CHNA process. Individual interviews were conducted in the Spring of 2015 with 33 community leaders and representatives. In addition, 6 listening sessions (4 English/1 Spanish/1 Burmese), with a total of 58 people, were held during April 2015. A community health summit was held September 10, 2015. Attendees were representative of the community and local and state leaders - 76 of the 119 invitees attended the summit. The summit attendees provided collective input into the needs of the community and available resources after the results of the secondary data review, community interviews, and survey were presented. Organizations providing input included: Meharry School of Dentistry, Metro Nashville Public Schools, Council on Aging, Jobs for Life, 61st Avenue United Methodist Church, Interdenominational Ministers Fellowship, Family & Children's Services, Healthy Nashville Leadership Council, Mayor's Office, 58th Legislative District, Nashville Government, Belmont University School of Health Sciences, Meharry Medical College, Metro Homelessness Commission, Saint Thomas Health, Nashville General Hospital, Vanderbilt Hospital, HCA Foundation, Urban Housing Solutions, Second Harvest Food Bank, Catholic Charities, Conexion Americas, Nashville Latino Health Coalition, Metro Police Department, Tennessee Justice Center, Crimestoppers, Mental Health America, YWCA, Metro Public Health Department, TSU, Center for Immigrants and Refugees of TN, Safety Net Consortium of Middle TN, Faith Family Clinic, Siloam Health, Matthew Walker Comprehensive Care Clinics, and MTA. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Saint Thomas West Hospital. The FISCAL YEAR 2016 CHNA was conducted in partnership between Saint Thomas Health and Vanderbilt University Medical Center. Saint Thomas Health partnering hospitals for the Davidson County CHNA include Saint Thomas Midtown Hospital, Saint Thomas Hospital for Specialty Surgery, and Saint Thomas West Hospital. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Saint Thomas West Hospital. Other organizations who served as partners in the conducting of this CHNA include the Metro Nashville Public Health Department, Metro Social Services, Family and Children's Services, United Way of Nashville and the Family Resource Centers. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Saint Thomas West Hospital. ST West works collaboratively within the community to improve the health. ST West provided the following programs and donations during the tax year to address the priority needs identified in the 2016 CHNA: Need: Access to Care/Care Coordination Programs: Medical Mission at Home, Charity Care Post-Discharge, Health Professions Education, Medical Library Donations: Saint Thomas Medical Partners' Family Health Centers, Hospital Hospitality House, Enroll America, Medical Missions Around the World, Room in the Inn, Linen Service for Ronald McDonald House and Room in the Inn, Tennessee Justice Center, Hope Smiles, Interfaith Dental Clinic, Middle TN Oral Health Coalition, Tennessee Charitable Care Network Need: Social Determinants/ Youth Issues Programs: Maplewood Academy Program, Metro Nashville Public Schools Workforce Development, and Saint Thomas Health Scholars Donations: The Contributor, Corner to Corner, Preston Taylor Ministries, Catholic Charities, Habitat for Humanity of Greater Nashville, Nashville Chamber Public Benefit Foundation, YMCA of Middle Tennessee Need: Mental and Emotional Health/ Substance Abuse Programs: None Donations: Begin Anew, Sexual Assault Center, Catholic Media Productions, Insight Counseling Centers, Hope Clinic for Women, First Steps, AGAPE, Building Lives Foundation, Open Table Nashville, and The Next Door Need: Wellness, Obesity, and Disease Prevention/ Management Programs: Faith Community Nursing Donations: New Beginnings, Nashville Downtown Partnership - B-cycle, Fannie Battle Day Home for Children, Faith Family Medical Center, Lutheran Services in Tennessee, Nashville Symphony, One Generation Away, Nashville Public Library, 2nd Chances/Kids and Kites, and Heimerdinger Foundation Saint Thomas Health provided the following programs and donations during the tax year to address the CHNA priority needs identified in the 2016 CHNA: Need: Access to Care/Care Coordination Programs: Charity Care Post-Discharge, Dispensary of Hope Charitable Pharmacies, Medical Missions at Home, Mobile Mammography, and Telemedicine Stroke Evaluation Donations: Hope Smiles Need: Social Determinants/Youth Issues Programs: Metro Nashville Public Schools Workforce Development, Health Professions Education CME Conferences, and Medical Library Donations: None Need: Mental and Emotional Health/Substance Abuse - No programs and donations Need: Wellness, Obesity, and Disease Prevention/Management - No programs and donations All identified needs were addressed during the fiscal year 0 Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH - PART I The Saint Thomas Health's governing body is comprised of persons representing diverse aspects and interests of the community. Many members of the Saint Thomas Health governing body reside in the organization's primary service area; who are neither employees nor independent contractors of the organization, nor family members thereof. Medical Staff: The organization extends medical staff privileges to all qualified physicians in its community for some or all of its departments or specialties. Patient care: ST West operates an emergency room open to all persons, regardless of ability to pay. The hospital participates in Medicaid, Medicare, TennCare, CHAMPUS, Tricare, and other government-sponsored health care programs. ST West provides financial assistance, both full and partial adjustments, to those who cannot afford to pay (both insured and uninsured). St. Thomas Health Foundation: One significant way in which Saint Thomas Health extends help and support into the community to promote health and well being is through the work of the Saint Thomas Health Foundation. The cornerstone work of the Foundation is supporting the needs of patients and families of ST DeKalb, ST Hickman, ST Highlands, ST Midtown, ST River Park, ST Stones River and ST West, particularly those who are struggling financially. A variety of funds including the Irene and Melvin Lewis, Transplant, Mandy Moore, the Francis Gluck Fund and the Watson Benevolent fund are specifically designed to pay for medical related costs as well as household expenses to ensure needy patients leaving our hospitals can properly heal at home. Over $75,000 was expended in FY2017 to the individual needs of such patients. Furthermore, one of the most active funds in the Foundation is the Community Health Outreach fund which expended over $434,000 in FY17 to support the needs of patients treated at our family health Centers and Clinics which help an underserved segment of our community population. There is also a fund available to all employees of Saint Thomas Health who are experiencing hardship. This fund, the Sister Juliana Beurlein Employee Financial Assistance Fund, offered system-wide over $90,000 in assistance in FY17. STH Senior Leaders and associates participate as active board members of non-profit organizations whose missions align with community health improvement and addresses social determinants of health. Medical Library: Medical Libraries are located on the campuses of Saint Thomas Midtown Hospital and Saint Thomas West Hospital. Librarians offer assistance in researching health information. Assistance is available to the broader community regardless of where medical care is obtained. In fiscal year 2017, librarians assisted individuals in researching 17 different topics. (Community Health Need: Access to Care) Health Professions Education: ST West serves as a clinical site for students attending many of the area nursing and allied health schools. An average of 93 students per month had clinical training at the hospital in fiscal year 2017, with more than 33,632 hours of clinical instruction on the hospital campus during the year. Additionally, ST West supports a Clinical Pastoral Education program, offering chaplaincy training in the clinical setting. (Community Health Need: Health Education and Access to Care) Faith Community Nursing (FCN): The program provides community health education and improvement through development of professional faith community nurses. The program provides training, continued education, support, resources and network to area FCN's. Additionally, the program promotes FCN to congregations as a holistic health and spiritual health promotion strategy. During fiscal year 2017, one Foundations of Faith Community Nursing was offered, and a total of 4 networking meeting were held. (Community Health Need: Wellness, Obesity, and Disease Prevention/Management) Middle Tennessee Oral Health Coalition: A coalition of oral health stakeholders was formed in 2014, with the financial support of STH, to address the current oral health system and work towards a sustainable system of care for vulnerable populations in Middle TN. STH advocacy and community health leaders participate in the coalition. (Community Health Need: Access to Care) Medical Missions at Home: A medical mission event was held in Davidson County within a low income community on September 24, 2016. Volunteers from all STH entities participated, and community volunteer providers offered health screenings, referrals, consultations, dental care, eye exams, glasses, health education, and a health ministry presence to persons who otherwise have limited access to health care. This one-day event, which included multiple volunteers and community partners, served 715 community members in a total of 1,894 encounters. (Community Health Need: Access to Care) Saint Thomas Health Scholars: In partnership with Metro Nashville Public Schools, the PENCIL Foundation, and the Nashville Area Chamber of Commerce, ST West supports the Saint Thomas Health Scholars, a cohort of roughly 100 MNPS seniors across 9 public high schools. Through the mentorship of a STH nurse educator, students are given job readiness and exam preparation training for medical industry certification examinations at the end of their senior year. The STH Nurse Educator travels to all 9 schools weekly to teach and mentor, and Scholars are brought to ST West and ST Midtown for various job shadowing and skills testing events throughout the school year. (Community Health Need: Social Determinants and Youth Issues) Shared Linen services for Ronald McDonald House and Room In The Inn: ST Midtown and ST West Hospitals participate in cost sharing of linen expenses for two area non-profits, one which addresses needs of the homeless and one addressing temporary housing for families of hospitalized families. (Community Health Need: Access to Care) Community Benefit Cash and In-Kind Contributions: ST West supports a variety of efforts and continues to work in collaboration with other community agencies to address the health and well-being of our community, especially the poor and vulnerable, including: The hospital has provided access to its conference rooms at no charge to some community organizations whose programs align with its mission. AGAPE: ST West and ST Midtown provide funds in support of AGAPE's sliding-fee payment scale for counseling, including Spanish-language counseling. (Community Health Need: Mental and Emotional Health) American Red Cross: ST West hosts periodic blood drives in conjunction with the local American Red Cross. (Community Health Need: Access to Care) Catholic Charities: ST West and ST Midtown Hospitals provide funds to support its work as the lead agency at the United Way's South Nashville Family Resource Center and McGruder Family Resource Center to provide health education, access to healthy food, mental health services, job readiness training, ESL and tutoring opportunities, and other social services. (Community Health Need: Wellness, Social Determinants, and Youth Issues) Catholic Media Productions: ST Midtown and ST West provide funds to support its programming intended to support the mental and emotional health of community members who listen to the radio programming, with a special focus on developing Spanish-language broadcasting. (Community Health Need: Mental and Emotional Health) Begin Anew: ST West and ST Midtown Hospitals provide funds to support its mission to empower individuals to break harmful cycles caused by poverty by providing education, mentoring and resources. Programs offered include GED test preparation, Life and Job Skills, and Conversational English Classes. (Community Health Need: Mental and Emotional Health) Building Lives Foundation: ST West and Midtown support Building Lives, which provides job readiness training, healthcare coordination, vehicle, and housing assistance to homeless veterans. (Community Health Need: Mental and Emotional Health, Care Coordination) Corner to Corner: ST Midtown and ST West provide funds to support its Launch program, a business entrepreneurship academy for underserved individuals and communities that equips community members experiencing a lack of economic opportunity to plan, start and grow small businesses. (Community Health Need: Social Determinants) Enroll America: ST Midtown, ST Rutherford and ST West provide funds to support its Get Covered America campaign, connecting uninsured individuals with resources to enroll in health insurance. (Community Health Need: Access to Care) Faith Family Medical Center: ST West and ST Midtown Hospitals provide support for its health education program Journey to Health, a comprehensive program aimed to reduce risk factors for obesity and chronic disease. (Community Health Need: Health Education) Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH - PART II Fannie Battle Day Home for Children: ST West and ST Midtown Hospitals provide support for fresh fruits and vegetables to be provided during meals and snacks. (Community Health Need: Health Education and Access to Healthy Food) First Steps: ST Midtown and ST West provide funds to support its pediatric outpatient therapy program, specifically to ensure services can be received regardless of ability to pay. (Community Health Need: Mental and Emotional Health) Heimerdinger Foundation: ST Midtown and ST West supported the Heimerdinger Foundation, which offers nutrient-dense, anti-inflammatory meals to cancer patients free of charge during treatment. Meals are prepared and delivered by volunteers using high-quality ingredients, and are for patients and their caregivers. (Community Health Need: Wellness, Obesity, and Disease Prevention/Management) Hope Clinic for Women: ST West and Midtown provide funds to support its mission to equip women, men and families to make healthy choices with unplanned pregnancies, prevention, pregnancy loss and postpartum depression, through its Prenatal & Parenting Education and their Mentoring and professional counseling programs and health care for women. (Community Health Need: Mental Health and Access to Care) Hope Smiles: ST West and ST Midtown Hospitals provide funds to support its participation in the health system's four Medical Missions at Home events. (Community Health Need: Access to Care) Hospital Hospitality House of Nashville: ST West and ST Midtown Hospitals provide funds to support families' basic needs, lodging, meals, and supportive care during times of extended medical treatment. (Community Health Need: Access to Care) Insight Counseling Centers: ST Midtown, ST Rutherford and ST West provide funds to support its Community Access Program, through which clients are extended financial assistance to remove financial barriers to needed mental health counseling support. (Community Health Need: Mental and Emotional Health) Interfaith Dental Clinic: ST West, ST Midtown, and ST Rutherford Hospitals provide funds to support its mission to provide oral health care and oral health education for uninsured, low-income working people, their families and the elderly. (Community Health Need: Access to Care) Lutheran Services in Tennessee: ST Hickman, ST Midtown, ST Rutherford and ST West provide funds to support the Healthy Gardens initiative, an individualized raised-bed garden program based in low-income housing communities that teaches families in poverty to grow their own vegetables, increasing the amount of nutritious food available and consumed. (Community Health Need: Wellness, Obesity, and Disease Prevention/Management) Nashville Downtown Partnership: ST West sponsors the B-cycle station at the Downtown Farmers Market. This shared bike program is implemented to increase active transportation and is aligned with Healthy People 2020 goals. (Community Health Need: Physical Activity and Wellness) Nashville Public Library: ST Midtown and ST West provided funding in support of Nashville Public Library's Be Well at NPL program, which brings health programs free of charge into all of Nashville's public library branches, with a special emphasis on those in low-income neighborhoods. Offerings include yoga, fitness, cooking on a budget, and therapeutic courses open to anyone in the community. (Community Health Need: Wellness, Obesity, and Disease Prevention/Management) Nashville Symphony: ST Midtown and ST West provide funds to support its Summer Outreach and Music Heals programs, bringing music into communities in need of healing. (Community Health Need: Wellness, Obesity, and Disease Prevention/Management) New Beginnings: ST West and ST Midtown provide funds to support its healthy lifestyle program for low-income women. The program uses physical fitness training, nutrition and health education, along with life coaching to improve overall health and well-being. (Community Health Need: Wellness, Obesity, Disease Prevention/Management) One Generation Away: ST Hickman, ST Midtown, ST Rutherford and ST West provide funds to support its mission of increasing access to healthy foods to those experiencing food insecurity. (Community Health Need: Wellness, Obesity, Disease Prevention/Management) Open Table Nashville: ST Midtown and ST West support Open Table Nashville's street chaplaincy residency program, offering chaplaincy services to those living on the street, as well as support for Open Table's general street outreach worker program. (Community Health Need: Mental and Emotional Health) Preston Taylor Ministries: ST West and ST Midtown Hospitals provide funds to support its mission to empower children and youth to reach their potential through the Preston Taylor Ministries one-on-one mentoring programs. (Community Health Need: Social Determinants and Youth Issues) Room In The Inn: ST West and ST Midtown Hospitals provide funds to support its mission of support for persons experiencing homelessness. The funds are restricted to holistic support of homeless individuals who have experienced a recent hospitalization and who would benefit from a transitional supportive living environment, including navigation of the health care system and obtaining necessary mental health services. (Community Health Need: Access to Care/Care Coordination) Sexual Assault Center: ST West, ST Midtown, and ST Rutherford provide funds to support their mission to provide healing for those affected by sexual assault and end sexual violence. The funds are restricted to provide treatment and mental health support to low-income clients. (Community Health Need: Mental and Emotional Health) Tennessee Charitable Care Network: ST Midtown and ST West supported the Tennessee Charitable Care Network, which offers resources and technical assistance to all charitable clinics in Tennessee providing care for the underserved. (Community Health Need: Access to Care) Tennessee Justice Center (TJC): ST Midtown, ST Rutherford, and ST West work together with TJC to improve access to care through providing enrollment assistance and training. The hospitals also provide financial support to TJC for this collaborative work. (Community Health Need: Access to Care) The Contributor: ST Midtown and ST West provide funds to support its Where To Turn in Nashville annual resource guide, providing direction to options for help for people experiencing poverty. (Community Health Need: Poverty/Social Determinants) The Next Door: Supported by ST West and ST Midtown, The Next Door offers drug treatment and rehabilitation to women, including pregnant women. This includes a residential facility with medically-monitored detox capabilities, as well as IOP programs. (Community Health Need: Mental and Emotional Health and Substance Abuse) Schedule H, Part VI, Line 6 PROMOTING THE HEALTH OF THE COMMUNITIES SERVED - PART I Saint Thomas West Hospital (ST West), established in 1898, is a 541-bed hospital in Nashville, Tennessee. It provides emergency room services and comprehensive inpatient and outpatient care, including transplantation and oncology services. The Hospital is part of Saint Thomas Health System and Ascension Health. Saint Thomas Health (STH) is Middle Tennessee's faith-based, not-for-profit health care system united as one healing community. Saint Thomas Health is focused on transforming the healthcare experience and helping people live healthier lives, with special attention to the poor and vulnerable. The regional health system included, in FY17, nine (9) hospitals: Saint Thomas Hospital for Specialty Surgery, Saint Thomas Midtown Hospital and Saint Thomas West Hospital in Nashville, Saint Thomas Rutherford Hospital in Murfreesboro, Saint Thomas Hickman Hospital in Centerville, Saint Thomas Stones River Hospital in Woodbury, Saint Thomas DeKalb Hospital in Smithville, Saint Thomas Highlands Hospital in Sparta, and Saint Thomas River Park Hospital in McMinnville. A comprehensive network of affiliated joint ventures, medical practices, clinics and rehabilitation facilities complements the hospital services. 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. Saint Thomas Health is a member of Ascension, a Catholic organization that is the largest not-for-profit health system in the United States. 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 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. Saint Thomas Health is committed to providing care to the communities it serves with attention to the poor and vulnerable. STH's mission provides a strong foundation and guidance for its work as a caring ministry of healing, including its commitment to community service and to provide access to quality healthcare for all. The STH Mission, Vision and Values are the key factors influencing their approach and commitment to addressing community health needs through their community benefit activity. Ascension's Socially Just Wage and Benefits Policy, established in 2001, applies to all of Ascension, including subsidiary entities and contractual third-party vendor relationships. Saint Thomas Health and Ascension are committed to providing a livable wage to all associates. Minimum wage within Ascension was raised to $11/hour during FY15. Catholic Social Teaching recognizes that each individual has a fundamental right to share in the fruits of her or his labor and to have basic needs met, including access to healthcare. An essential component of the Socially Just Wage Policy is the employer subsidization of the cost of healthcare insurance for lower-paid associates. This employer subsidy, combined with the minimum hourly wage rate, provides affected associates with a decent standard of living and affordable access to healthcare. (Community Health Need: Access to Care and Wellness) Saint Thomas Health supports a variety of efforts and continues to work in collaboration with other community agencies to address the health and well-being of our community, especially the poor and vulnerable, including restricted cash donations to outside organizations, in-kind donation of employee time/services to outside organizations and representation on community/non-profit boards and committees which work to improve the health and quality of life of the communities we serve. As a system, STH supports a variety of efforts specifically aimed at providing services for persons who are poor and vulnerable, and at improving the health of the community. For example, in fiscal year 2017: Continuing Medical Education: STH offers a variety of online accredited continuing medical education courses. Additionally, in-person seminars on various health topics are offered. The courses are open to all physicians and health professionals. During FY17, 7 educational courses/seminars were offered with total attendance of 435. (Community Health Need: Health Education and Access to Care) Graduate Medical Education: STH and its Affiliates serves as training sites for University of Tennessee, Meharry Medical College and Vanderbilt University medical residents. In fiscal year 2017, 92 medical residents received graduate medical education training at a Saint Thomas Health site. (Community Health Need: Health Education and Access to Care) Medical Missions at Home: STH organized three medical mission events, one in Davidson County, one in Warren County, and one in Rutherford County, each held within a low-income community. Volunteers from all STH entities participated, and community volunteer providers offered health screenings, referrals, consultations, dental care, eye exams, glasses, health education, and a health ministry presence to persons who otherwise have limited access to health care. In FY17, these events served 1,395 community members in a total of 3,702 encounters resulting in 155 scheduled follow-up appointments. (Community Health Need: Access to Care) Saint Thomas Medical Partners Family Health Centers: The mission of the Saint Thomas Medical Partners' network of family health clinics is to serve the community by providing health care to all ages regardless of insurance status or financial resources. All clinics are staffed by licensed medical professionals. For those who do not have insurance, clinic fees are discounted 46% with additional discounts given for paying day of service. For those who qualify for financial assistance, patient balances are adjusted. In addition, private insurance, Medicare and TennCare are accepted. STH operates 7 primary care safety-net clinics, with one specifically focused on women's health care. These sites provided 91,217 patient encounters for 27,493 patients in fiscal year 2017. The clinics are committed to providing high-quality primary care to the uninsured and underinsured, and they serve the Davidson, Hickman, and Rutherford County communities. These clinics serve as a medical home for many patients; acute medical care is provided typically on the same day, and patients with chronic illnesses are seen routinely. The clinics offer a broad range of health care. For patients struggling with mental health issues, a Psychiatric Nurse Practitioner and licensed social worker are available at certain clinics; chaplaincy services are also an available support at certain clinics. The clinics utilize the services of the Dispensary of Hope to provide convenient access to free and reduced-cost medications. Social workers and trained nurses also help patients request free medications through the Patient Assistance Program Referral Services. The clinics work to ensure access to specialty services by linking patients to other resources within the community. The South Clinic, West Clinic, and St. Louise clinic also offer additional services: each clinic has a nutritionist available to help patients with better food choices and initiate weight loss if needed, and each has a pharmacist on site to assist with medication management and medication education within their patient population. Additionally, the South Clinic offers Clinica Nueva Vida - a comprehensive prenatal care program for uninsured, low income Hispanic women in Greater Nashville, combined with medical monitoring. The St. Louise clinic offers a pharmacotherapy program with strong focus on CHF. Schedule H, Part VI, Line 6 PROMOTING THE HEALTH OF THE COMMUNITIES SERVED - PART II Our Mission in Motion: The mobile mammography outreach program is designed to increase access to high quality screening mammography for all women, with special attention to the poor and vulnerable in Middle Tennessee. The program provides screening mammograms in collaboration with local employers, communities, and safety net clinics, reducing the barrier of transportation and inability to afford time away from work. Screening mammograms are available to the uninsured. When indicated, Our Mission in Motion works with women to connect them to follow up care. It is the goal of the program to improve the compliance rates for screening mammography by making services accessible and affordable, thus decreasing the late stage detection of breast cancer for women in Middle Tennessee. Women delay their annual mammograms for numerous reasons, with the most common including lack of insurance, financial barriers, and the inability to take time off work to receive one. In fiscal year 2017, 2,974 screenings were performed at 200 stops. 389 women received mammography screening for the first time, and 1008 women were screened who had not had a mammogram in over two years. (Community Health Need: Access to Care and Wellness) Advocacy for Health: STH is a founding member and active member of the Middle Tennessee Consortium of Safety Net Providers, which works to provide quality, affordable medical homes for the uninsured and specialty care services on a sliding scale based on household income. Saint Thomas Health Foundation serves as the legal and fiduciary agent to the Consortium. The Board of Directors that governs the Consortium is comprised of health care providers and local business leaders who serve the low-income and uninsured. STH is committed to ensuring 100% access to care for everyone, with special attention to those who live in poverty and struggle the most; STH actively advocates for healthcare access and coverage for all persons through grassroots outreach and ongoing meetings with elected officials. STH's advocacy work communicates CHNA findings and works with federal, state, and local officials to create and shape public policy to meet the needs identified by the community. STH provides sponsorship of community events as well as presentations to increase awareness and educate the public regarding healthcare reform and access. STH Senior Leaders participate as active board members of non-profit organizations whose mission is aligned with community health improvement. STH representatives also participate in county health councils. (Community Health Needs: Access to Care) Dispensary of Hope Charitable Pharmacies: Since 2006, the Dispensary of Hope Pharmacy has provided medication assistance for uninsured and underinsured individuals who are experiencing financial hardship. In fiscal year 2017, 23,973 prescriptions were filled, a total value of $352,111 in 10,734 total patient encounters at the Saint Thomas West Hospital location; additionally, $40,233.75 worth of medications were obtained through the Prescription Assistance Program. The pharmacy located in Rutherford County dispensed 24,884 prescriptions in a total of 12,236 patient encounters at a value of $507,455 in fiscal year 2017. A third pharmacy located on the Saint Thomas Midtown hospital campus filled 32,724 prescriptions, a total value of $643,616, in 11,763 patient encounters during fiscal year 2017; additionally, $20,454.45 worth of medication were obtained through the Prescription Assistance Program. (Community Health Need: Access to Care and Wellness) Camp Bluebird: STH is a founding partner and primary supporter of Camp Bluebird and draws volunteers from Saint Thomas Health, the community and other community hospitals. Camp Bluebird was the first camp in the Middle Tennessee area designed for adult cancer patients. For three days and two nights volunteers provide adult campers with education, support and encouragement in living life after a cancer diagnosis. Camp is held each Spring and Fall, with 120 cancer patients participating in fiscal year 2017. (Community Health Need: Health Education and Wellness) 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 6a Community benefit report prepared by related organization Saint Thomas Health, EIN: 62-1836937 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part II Community Building Activities SOCIAL DETERMINATES ARE THE CONDITIONS OF COMMUNITIES WITHIN WHICH PEOPLE LIVE THAT AFFECT THEIR HEALTH AND WELL-BEING AND INCLUDE HOUSING, CRIME, POVERTY, EDUCATION, DISCRIMINATION, AND OTHERS. ADDRESSING THE SOCIAL DETERMINATES OF HEALTH THROUGH COMMUNITY BUILDING IS AN IMPORTANT COMPONENT IN IMPROVING THE CONTRIBUTING FACTORS THAT DETERMINE THE HEALTH OF THE COMMUNITY. ST WEST SUPPORTS A VARIETY OF EFFORTS AND CONTINUES TO WORK IN COLLABORATION WITH OTHER COMMUNITY AGENCIES TO ADDRESS THE HEALTH AND WELL-BEING OF THE COMMUNITY, ESPECIALLY THE POOR AND VULNERABLE, INCLUDING REPRESENTATION ON COMMUNITY/NON-PROFIT BOARDS AND COMMITTEES WHICH WORK TO IMPROVE THE HEALTH AND ADDRESS ITS SOCIAL DETERMINATES. Workforce Development: Understanding the strong correlation between income level and physical health, Saint Thomas West Hospital supports workforce development through engagement with Metro Nashville Public Schools. Through hospital tours and job shadows with St. Thomas associates, low-income high school students are exposed to viable, well-paying careers in healthcare, encouraging them to consider these career paths which can lead to financial security and, ultimately, better overall health for themselves, their families, and their communities. Coalition Building: Saint Thomas West Hospital supports coalition building through hospital leaders' participation on community boards. Representing Saint Thomas, associates use their time to help lead nonprofit organizations as they work to improve the overall well-being of the community. This collaborative work encompasses the issues of healthcare, economic vitality, education, housing/homelessness, youth issues, and more. Organizations include: Better Business Bureau, Williamson County Chamber of Commerce, Nashville Area Chamber of Commerce/COE Council of Academy Programs - Metro Nashville Public Schools, Siloam Health, American Heart Association, Room In The Inn, Saint Vincent de Paul Society, Boy Scouts of America, Amazima Ministries, Hospital Hospitality House, Habitat for Humanity, Nashville Health, UK MHA Board of Advisors, Tennessee Hospital Association, Nashville Health Care Council, Tennessee Business Roundtable, Alive Hospice, and Diocese of Nashville Board. 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. Schedule H, Part III, Line 3 Bad Debt Expense Methodology The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 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 SAINT THOMAS WEST HOSPITAL FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED. Schedule H, Part V, Section B, Line 16a FAP website - Saint Thomas West Hospital: Line 16a URL: https://www.sthealth.com/patients-and-visitors/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - Saint Thomas West Hospital: Line 16b URL: https://www.sthealth.com/patients-and-visitors/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Saint Thomas West Hospital: Line 16c URL: https://www.sthealth.com/patients-and-visitors/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment Saint Thomas West 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 areas of need and include but are not limited to reports from: -Tennessee Department of Health -Nashville Metropolitan Planning -Tennessee Department of Education -Tennessee Department of Labor -University of Wisconsin Population Health Institute - County Health Ratings -Family & Children's Services -Metro Nashville Social Services -Tennessee Bureau of Investigation -Feeding America -Enroll America -US Department of Health and Human Services -Healthy Nashville -US Central Intelligence Agency -US Census Bureau -Centers for Disease Control and Prevention Saint Thomas West Hospital utilizes information from these secondary sources to develop programs and provide services throughout the region. In addition, Saint Thomas West 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 Education of eligibility for assistance at Saint Thomas West Hospital begins at registration with signage displayed at all registration points notifying patients that we have a Financial Assistance Program, as well as contact information for the patient to use should they need assistance. Plain Language Summaries of the FAP containing this information are also offered to patients at all registration points. The FAP, FAP Application and Plain Language Summary are also available in multiple languages based on LEP requirements in our community. Saint Thomas West Hospital's registration associates discuss the estimated balance that will be due with both insured and self-pay patients. Should the associate identify that the patient may need assistance with that balance he/she will provide the patient with a Financial Assistance Application and help them complete it, if needed. All self-pay and underinsured patients are screened by Saint Thomas West Hospital for alternative coverage including Medicaid, SSI/SSD, Cobra, student coverage, and crime victims' compensation. If no alternative is identified then an associate will work with the patient to complete a Financial Assistance Application. Also, contact information is listed on Saint Thomas West Hospital billing statements for the patient to use in the event they need assistance with their balances. A Plain Language Summary is also mailed 30 days in advance of an Extraordinary Collection Activity occurring. Collections associates have been trained to offer patients a Financial Assistance application if needed by the patient. Saint Thomas West Hospital works with third party collection vendors who are required to follow the Hospital's Financial Assistance Policy. A third party vendor is also used to perform presumptive charity scoring on all accounts prior to bad debt placement to identify any accounts that may qualify presumptively for financial assistance even if a patient did not request to apply for financial assistance. A plain language summary of the Financial Assistance Policy, FAP, FAP Application and list of Providers Covered under the FAP can all be found on our website at http://sthealth.com/patients-and-visitors/financial-assistance in all required LEP languages. Schedule H, Part VI, Line 4 Community information Located in Nashville, Tennessee, Saint Thomas West Hospital (ST West), primarily serves residents of Davidson County and adjacent surrounding counties of Middle Tennessee and has a strong Cardiac Service Line. A majority of ST West's emergency visits are from Davidson County. Davidson County is one of 95 counties within the state of Tennessee and is located in the Middle Tennessee region. Tennessee is located in the Southeastern region of the United States. Davidson County has urban, suburban and rural areas and encompasses 504 square miles, having a population density of 1243.3 persons per square mile. United States Census Quick Facts for 2016 indicates an estimated population of 684,410. 2016 Community Demographic highlights include: 51.8% Female; 65.2% White; 28.1% African American; 6.9% Persons under 5 years; 11.5% Persons 65 years and over; 87.3% High school graduate or higher (% persons age 25+, 2011-2015); 23.8 minutes, mean travel time to work (2011-2015); $28,589 per capita income in the past 12 months (2011-2015); $48,368 median household income (2011-2015); and 17.1% persons in poverty (2011-2015). American Fact Finder, American Community Survey (2010-2014 5Year Estimates) notes 16.4% of the total civilian noninstitutionalized population and 7.1% of children (ages 0-17), 21.8% ages 18-64, 1.3% 65 years and older, and 24.2% ages 19-25 in Davidson County were uninsured. According to the Tennessee Department of Health's 2016 Joint Annual Report of Hospitals https://apps.health.tn.gov/publicjars/default.aspx Davidson County has 14 hospitals: 10 General and Specialty Hospitals with a combined 3,339 staffed beds (3,790 licensed beds); One Mental Health Hospital with 207 staffed beds out of 370 licensed beds; and 3 Long Term/Rehab hospitals with 206 staffed beds out of 210 licensed beds. There are areas designated as medically underserved within Davidson County. For a complete description of the community demographics and selection for CHNA purposes, please review the Hospital's CHNA online at: http://www.sthealth.com/about-us/mission-integration/community-health/community-health-needs-assessment true CATHOLIC CHARITIES OF TENNESSEE INC 2806 MCGAVOCK PIKE Nashville TN 37214 620679520 501(c)(3) 52000 Support the South Nashville Family Resource Center and the McGruder Family Resource Center (North Nashville) FAITH FAMILY MEDICAL CENTER 326 21ST AVE N Nashville TN 37203 621816811 501(c)(3) 10000 Support the Journey to Health education program FANNIE BATTLE DAY HOME FOR CHILDREN 108 CHAPEL AVE Nashville TN 37206 620476290 501(c)(3) 10000 Providing fresh fruits and vegetables to children. INTERFAITH DENTAL CLINIC 1721 PATTERSON ST Nashville TN 37203 621567615 501(c)(3) 22667 Improving the oral and overall health of the dentally underserved in Middle Tennessee TENNESSEE JUSTICE CENTER INC 301 CHARLOTTE AVE Nashville TN 37201 621630417 501(c)(3) 10834 Help vulnerable families access health coverage THE NEW BEGINNINGS CENTER 509 CRAIGHEAD ST Nashville TN 37204 900751722 501(c)(3) 17500 Fund the program costs of low-income women SAINT THOMAS NETWORK 4220 Harding Rd Nashville TN 37205 621868848 501(c)(3) 947982 Provide support for Saint Thomas Family Health Center's clinic operations Nashville Symphony Schermerhorn Symphony Center One Symphony Place Nashville TN 37101 620550979 501(c)(3) 12500 Support the Summer Outreach and Music Heals programs Hope Clinic for Women 1810 Hayes Street Nashville TN 37203 621164825 501(c)(3) 6000 Support the Hope Clinic for Women's Bridges to Maternal Care Program Hospital Hospitality House of Nashville 214 Reidhurst Avenue Nashville TN 37203 620909363 501(c)(3) 6000 To provide a home away from home for families and patients who travel to Nashville for medical care OPEN TABLE NASHVILLE 210 Morton Ave Nashville TN 37211 273514899 501(c)(3) 25000 To stregthen the outreach, housing support and chaplaincy programs NASHVILLE PUBLIC LIBRARY FOUNDATION 615 Church Street Nashville TN 37219 621681766 501(c)(3) 12500 Support Be Well at NPL: Advancing health equity through free access to physicial activity, nutrition education, and health resources at Nashville Public Library (NPL) HOPE SMILES 115 Penn Warren Drive Brentwood TN 37027 260829468 501(c)(3) 12750 To improve access to dental care for the underserved in Middle Tennessee THE NEXT DOOR 402 22nd Avenue North Nashville TN 37203 432001774 501(c)(3) 10000 Treatment and support of uninsured patients HABITAT for HUMANITY of GREATER NASHVILLE 2950 Kraft Drive Nashville TN 37204 581636286 501(c)(3) 30000 Construction of a home ASSOCIATION for GUIDANCE AID PLACEMENT & EMPATHY (AGAPE) 4555 Trousdale Drive Nashville TN 37204 620760716 501(c)(3) 10000 Provide access to mental health counseling for low income Hispanic population TENNESSEE CHARITABLE CARE NETWORK 2817 West End Avenue Nashville TN 37203 464916133 501(c)(3) 8000 To increase additional programs and services and provide technical assistance to member organizations BUILDING LIVES FOUNDATION INC PO Box 210184 Nashville TN 37221 205584526 501(c)(3) 7500 Provide support for staffing and transportation for the Academy Program CHRISTIAN WOMEN'S JOB CORPS OF MIDDLE TN'S (DBA BEGIN ANEW OF MIDDLE TN) 420 MAIN STREET Nashville TN 37206 760718734 501(c)(3) 6250 Support the Mental/Physicial Health Case Management and Mentoring program. CORNER TO CORNER 812 North 5th Street Nashville TN 37207 473007704 501(c)(3) 7500 To expand the Business Entrepreneurship Academy for Underserved Communities NASHVILLE DOWNTOWN PARTNERSHIP 150 4th Ave N Nashville TN 37219 621774641 10000 Nashville bike stations PRESTON TAYLOR MINISTRIES PO Box 90442 Nashville TN 37209 621757018 501(c)(3) 7000 PTM's One-on-One mentoring programs YMCA OF MIDDLE TENNESSEE 1000 Church Street Nashville TN 37203 620476243 501(c)(3) 50000 Improving community health 22 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Organizations requesting grants are asked to submit a request in writing which identifies the community health need the grant will be addressing, along with goals and objectives. Requests are reviewed by the Saint Thomas Health Community Health & Benefit Committee prior to approval. Awarded grantees are asked to submit a report of program/event activities. It is requested the report include demographic summary of population benefited and achieved objectives and impact on health. The reports are reviewed by the Community Health & Benefit Team in a broad manner upon receipt, but will be more thoroughly scrutinized if the grant recipient comes back to ask for a renewal or another grant. true true false false false false false false false KAREN L SPRINGER BOARD MEMBER & PRESIDENT/CEO STHE 0 609999 0 482675 0 192646 0 14575 0 5501 0 1305396 0 0 MICHAEL H SCHATZLEIN MD FORMER OFFICER (END 3/2016) 0 980084 0 1692000 0 456344 0 14575 0 22798 0 3165801 0 0 ALAN STRAUSS FORMER OFFICER (END 4/2012) 0 16274 0 0 0 607793 0 1020 0 6899 0 631986 0 0 BERNARD J SHERRY FORMER OFFICER (END 8/2015) 0 745387 0 575928 0 237996 0 17226 0 28294 0 1604831 0 0 PAMELA M HESS CFO STW/STM (END 7/2016) 150722 149167 0 61995 9532 42023 9280 6620 9368 11363 178902 271168 0 0 DON E KING CEO/PRESIDENT STW/STM 0 414820 0 201654 0 34904 0 14575 0 25060 0 691013 0 0 MARK MARSDEN MD CHIEF MEDICAL OFFICER 387456 0 94871 0 12789 0 13250 0 22957 0 531323 0 0 0 JENNIFER ELLIOTT CNO (END 12/2016) 0 211521 0 53675 0 32223 0 7950 0 21387 0 326756 0 0 CARRIE B TEAFORD COO STW/STM 280338 0 61190 0 27175 0 17225 0 15219 0 401147 0 0 0 MATTHEW JOSSEPH MD PHYSICIAN 409205 0 10000 0 304 0 10981 0 12311 0 442801 0 0 0 KYRIAKOS KYRIAKIDIS MD PHYSICIAN 379351 0 11250 0 1477 0 14651 0 25590 0 432319 0 0 0 EUGENE F LAFRANCHISE MD PHYSICIAN 505752 0 0 0 4690 0 14575 0 28378 0 553395 0 0 0 MICHAEL MEADORS MD PHYSICIAN 355127 0 11250 0 697 0 15900 0 19886 0 402860 0 0 0 STEVEN TARQUINE MD PHYSICIAN 385193 0 11250 0 869 0 14575 0 22843 0 434730 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Ascension Health, a related organization of Saint Thomas West Hospital, uses the following to establish the compensation of the organization's CEO: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Comensation Committee Schedule J, Part I, Line 4a Severance or change-of-control payment The following individual(s) received severance payments from the organization or a related organization: JENNIFER ELLIOTT - $6,731 ALAN STRAUSS - $559,923 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No individuals received current year distributions. Form 990, Part IV, Line 20b Explanation of financial statements The activity of Saint Thomas West Hospital ("STWH") is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of STWH is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of STWH. 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 ASCENSION HEALTH AND ITS SUBSIDIARY ORGANIZATIONS. ASCENSION HEALTH IS THE NATIONAL HEALTH SYSTEM PARENT. 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 SAINT THOMAS HEALTH AND ITS SUBSIDIARY ORGANIZATIONS. SAINT THOMAS HEALTH IS THE MINISTRY HEALTH SYSTEM PARENT. 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 Saint Thomas West Hospital has a single corporate member, Saint Thomas Health. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Saint Thomas West Hospital has a single corporate member, Saint Thomas Health, who has the ability to elect members to the governing body of the hospital. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Saint Thomas West Hospital's financial information or corporation as a whole are subject to approval by its sole corporate member, Saint Thomas Health. Ascension Health, the sole corporate member of Saint Thomas Health, has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. 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 conflict 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 VIII, Line 11d Other Miscellaneous Revenue Other Revenue - Total Revenue: 828884, Related or Exempt Function Revenue: 828884, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Net Assets Trans To From Alpha - 30387494; Deferred Pension Cost - -9227050; Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant Saint Thomas West Hospital is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 631355998 453358926 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I ASCENSION HEALTH ALLIANCE false SAINT THOMAS HEALTH 4220 HARDING ROAD NASHVILLE TN 37205 581716804 SYSTEM PARENT TN 501(c)(3) Type III-FI ASCENSION HEALTH false SAINT THOMAS NETWORK 4220 HARDING ROAD NASHVILLE TN 37205 621284994 HEALTH INVESTMENT ENTITY TN 501(c)(3) 10 SAINT THOMAS HEALTH true SAINT THOMAS HEALTH FOUNDATIONS PO BOX 380 NASHVILLE TN 37202 581663055 OPERATES FOUNDATION TN 501(c)(3) 7 SAINT THOMAS NETWORK true SAINT THOMAS RUTHERFORD HOSPITAL 1700 MEDICAL CENTER PARKWAY MURFREESBORO TN 37219 620475842 HOSPITAL TN 501(c)(3) 3 SAINT THOMAS HEALTH true SAINT THOMAS RUTHERFORD FOUNDATION 1700 MEDICAL CENTER PARKWAY MURFREESBORO TN 37219 621167917 FOUNDATION TN 501(c)(3) Type I SAINT THOMAS RUTHERFORD HOSPITAL true SAINT THOMAS MIDTOWN HOSPITAL 4220 HARDING ROAD NASHVILLE TN 37205 621869474 ACUTE CARE HOSPITAL TN 501(c)(3) 3 SAINT THOMAS HEALTH true BAPTIST HOSPITAL FOUNDATION OF NASHVILLE INC 2000 CHURCH STREET NASHVILLE TN 37236 581861378 INACTIVE TN 501(c)(3) Type I SAINT THOMAS MIDTOWN HOSPITAL true BAPTIST HEALTH CARE AFFILIATES INC 2000 CHURCH STREET NASHVILLE TN 37236 581509251 COMMUNITY HEALTH PROMOTION TN 501(c)(3) Type I SAINT THOMAS NETWORK true SAINT THOMAS MEDICAL PARTNERS 2000 CHURCH STREET NASHVILLE TN 37236 621529858 HEALTHCARE PROVIDER TN 501(c)(3) 3 SAINT THOMAS NETWORK true SAINT THOMAS HICKMAN HOSPITAL 135 EAST SWAN STREET CENTERVILLE TN 37033 581737573 HOSPITAL TN 501(c)(3) 3 BAPTIST HEALTH CARE AFFILIATES INC true SAINT THOMAS HOME HEALTH 135 EAST SWAN STREET CENTERVILLE TN 37033 621836937 HOME HEALTH CARE TN 501(c)(3) 10 SAINT THOMAS HICKMAN HOSPITAL true SAINT THOMAS REGIONAL HOSPITALS 4220 HARDING PIKE NASHVILLE TN 37205 474063046 HOSPITALS TN 501(c)(3) 3 SAINT THOMAS HEALTH true BAPTIST WOMENS HEALTH CENTER LLC 1900 CHURCH STREET SUITE 300 NASHVILLE TN 37203 621772195 OWNS AND OPERATES SPECIALTY HOSPITAL TN NA N/A STHS SLEEP CENTER LLC 102 WOODMONT BOULEVARD SUITE 800 NASHVILLE TN 37205 203664894 OPERATES A SLEEP CENTER TN NA N/A MIDDLE TENNESSEE IMAGING LLC 400 N HIGHLAND AVENUE MURFREESBORO TN 37219 010570490 DIAGNOSTIC IMAGING CENTER TN NA N/A RADS OF AMERICA LLC PO BOX 249 GOODLETTSVILLE TN 370700249 200597581 AMBULATORY SURGERY CENTER TN NA N/A MURFREESBORO DIAGNOSTIC IMAGING LLC 400 N HIGHLAND AVENUE MURFREESBORO TN 37219 200291952 DIAGNOSTIC IMAGING CENTER TN NA N/A SOVA INC 102 WOODMONT BOULEVARD SUITE 700 NASHVILLE TN 37205 261319638 HEALTH SERVICES TN NA C Corporation true BAPTIST HEALTH CARE VENTURES INC 2000 CHURCH STREET NASHVILLE TN 37236 620469214 HOLDING COMPANY TN NA C Corporation true Ascension Care Management Health Partners Tennessee (fka MISSIONPOINT HEALT H PARTNERS) 523 Mainstream Drive NASHVILLE TN 37228 452958482 ACCOUTABLE CARE ORGANIZATION TN NA C Corporation true MID-STATE PROPERTIES INC 2000 CHURCH STREET NASHVILLE TN 37236 621232018 INACTIVE TN NA C Corporation true false true true false false false false false false true true true true false true true true true true Baptist Health Affiliates P 1482000 FMV Saint Thomas Medical Partners L 506326 FMV Saint Thomas Medical Partners M 55209 FMV Saint Thomas Medical Partners O 3583737 FMV Saint Thomas Medical Partners P 1120797 FMV Saint Thomas Medical Partners Q 7768193 FMV Saint Thomas Medical Partners S 39777650 FMV Saint Thomas Network B 947982 FMV Saint Thomas Network P 182551 FMV Saint Thomas Midtown Hospital L 41690118 FMV Saint Thomas Midtown Hospital S 109148548 FMV Saint Thomas Rutherford Foundation P 56933 FMV Saint Thomas Rutherford Hospital L 28638845 FMV Saint Thomas Rutherford Hospital M 577440 FMV Saint Thomas Rutherford Hospital S 97992769 FMV Saint Thomas Health Foundations C 270000 FMV Saint Thomas Health Foundations L 269091 FMV Saint Thomas Regional Hospitals L 7137577 FMV Saint Thomas Regional Hospitals R 20655879 FMV Schedule R, Part II Saint Thomas Medical Partners Due to a corporate reorganization during FY 2017, the sole corporate member of Saint Thomas Medical Partners changed from Saint Thomas Network to Ascension Medical Group, a disregarded entity of Ascension Health, EIN 31-1662309. At that time, Saint Thomas Medical Partners ceased to be a member of the Ascension Tennessee group.