2017-05-12T15:00:15-05:00 2016-06-30 990 2015-07-01 351869951 CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES INC CENT 3173387080 10330 N MERIDIAN STREET SUITE 430N INDIANAPOLIS IN 46290 JONATHAN NALLI SYSTEM CEO 2017-05-12 2015 2021-01-29 14:40:06Z JONATHAN NALLI 10330 N MERIDIAN STREET INDIANAPOLIS IN 46290 81150624 false 0928 X WWW.STVINCENT.ORG X 1991 IN St. Vincent Heart Center of Indiana strives to create a just and compassionate health care environment. 2 0 541 0 0 0 23613 11379 0 0 2546308 883249 64275687 79956747 66845608 80851375 0 0 0 0 40365118 37075401 0 0 0 4996024 11696067 45361142 48771468 21484466 32079907 247155854 309439407 61659624 91395366 185496230 218044041 To own free standing outpatient and diagnostic cardiac catherization laboratories and support other entities that provides cardiac services to the community and to support and encourage the activities and purposes of Ascension Health and St. Vincent Health. false false 43512293 79526471 Central Indiana Health System Cardiac Services, Inc. (CIHSCS) owns a 74.08% interest in St. Vincent Heart Center of Indiana, LLC (SVHC), a licensed hospital. SVHC is a specialized cardiovascular hospital serving Hamilton and contiguous counties and providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2016, SVHC treated 4,437 adults and children for a total of 19,901 patient days of service. The hospital also provided services for 11,420 outpatient visits, including 168 outpatient surgeries and 2,915 emergency room visits. St. Vincent Heart Center of Indiana, LLC is dedicated to providing spiritually-centered, holistic healthcare that sustains and improves the health of those served, with special attention to the poor and vulnerable. Both inpatient and outpatient health services are provided without regard to patient race, creed, national origin, economic status, insurance status or ability to pay. This mission extends well beyond the provision of core medical services to encompass medical and scientific research programs, the training and educating of health care professionals and active support of community-based partnerships and programs to improve health and quality of life. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 43512293 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 false true true true true false false true 45 0 true 541 true false false false false false false false false false false X 2 0 false false false false true true true true true false false true true true true true true false true true true IN X ELLEN FERRINGER 3175833294 10330 N MERIDIAN STREET INDIANAPOLIS IN 46290 MICHAEL L MULLINS SYSTEM VP-MINISTRY OPERATING EXEC 0.2 40.8 X X 0 674465 42590 JONATHAN NALLI CHAIR - SYSTEM CEO 0.2 41.0 X X 0 1451152 50024 BLAKE A DYE PRESIDENT-SVHCI 40.0 0.2 X 808802 0 40371 MICHAEL K SCHROYER COO - SVHCI 20.0 21.2 X 281513 8806 42375 BECKY L JACOBSON VP FINANCE - SVHCI 40.0 0 X 232111 0 32960 JOSEPH B LANDIS TEAM LEAD CATH - SVHCI 40.0 0 X 186134 0 28839 ALEX W LEE DIRECTOR - PHARMACY 40.0 0 X 139467 0 33902 KAREN B RICHMOND OR NURSE - SVHCI 40.0 0 X 136953 0 21787 JEFFERY L BOARDS RN - CARDIOVASCULAR 40.0 0 X 153605 0 22324 LORI L SHANNON CARDIOVASCULAR RN - SVHCI 40.0 0 X 231698 0 13323 JULIE M CARMICHAEL FORMER OFFICER 0.0 0.0 X 0 429459 16407 IAN G WORDEN FORMER OFFICER 0.0 0.0 X 0 289650 1004 2170283 2853532 345906 33 true true false MID AMERICA CLINICAL LABORATORIES PO BOX 642263 PITTSBURGH PA 15264 LAB SERVICES 2561584 SOUTH BEND MEDICAL FOUNDATION 530 N LAFAYETTE BLVD SOUTH BEND IN 466011004 LAB SERVICES 536241 FRESNIUS MANAGEMENT SERVICES 10585 N MERIDIAN ST STE 160 INDIANAPOLIS IN 46290 COMMERCIAL SERVICES 222614 MVP PROFESSIONAL COATINGS LLC 7832 HUFF ST INDIANAPOLIS IN 46259 DRYWALL AND PAINT CONTRACTOR 108676 JACK LAURIE COMMERCIAL FLOORS 7998 GEORGETOWN ROAD INDIANAPOLIS IN 46268 FLOORING SERVICES 108055 5 11379 11379 0 0 0 0 0 883249 883249 729525 299249 430276 0 430276 430276 0 0 JOINT VENTURE INCOME 900099 31836093 31836093 PAYROLL SERVICE REVENUE 541200 37075401 37075401 MANAGEMENT FEES 541900 10614977 10614977 0 0 0 0 79526471 80851375 79526471 0 1313525 1436755 1436755 27494982 25274680 2220302 1063096 977248 85848 5341173 4909857 431316 1739395 1598934 140461 3601629 3310787 290842 116429 107027 9402 121717 111888 9829 0 2387868 2195040 192828 CORPORATE EXPENSES 5440375 5001048 439327 Miscellaneous Expense 27872 25621 2251 SUPPLIES 177 163 14 0 0 0 0 48771468 43512293 5259175 0 35454507 41219008 29083966 55932310 0 0 2298627 1979955 222184 73171 69532572 46161755 24977709 23370817 0 8000000 8000000 46896257 55623667 100222604 123240479 247155854 309439407 9163570 9682208 52496054 81713158 61659624 91395366 X 185496230 218044041 185496230 218044041 247155854 309439407 X 32079907 -2653429 3121333 X false true X true true true X X 1 ST VINCENT HOSPITAL AND HEALTH CARE CENTER INC 350869066 3 true 0 0 1 0 0 true false false false false false false false false false false false false false false true true true X true true Schedule A, Part I, Line 11 AMOUNTS OF OTHER SUPPORT CHISCS LEASES REAL ESTATE TO ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC. Schedule A, Part IV, Section C, Line 1 Supp. Org. Have Significant Voice In Investment Policies BY VIRTUE OF OVERLAPPING BOARD MEMBERS, THE SUPPORTED ORGANIZATIONS HAVE A SIGNIFICANT VOICE IN THE SUPPORTING ORGANIZATION'S DAILY OPERATIONS. THE ASCENSION SPONSOR, THROUGH ITS CONTROL OF THE ASCENSION BOARD, CONTROLS THE SYSTEM INTEGRATED STRATEGIC OPERATIONAL FINANCIAL PLAN, ANNUAL TARGETS AND INITIATIVES. WITHIN THIS OPERATIONAL FRAMEWORK, CERTAIN EXPENDITURES OF FUNDS, CAPITAL INVESTMENTS, ISSUANCE OF DEBT, ETC. ARE SUBJECT TO ASCENSION-LEVEL APPROVAL. Schedule A, Part IV, Section E, Line 1a Org. Activities Directly Further The Exempt Purposes Central Indiana Health System Cardiac Services, Inc. provides outpatient and diagnostic cardiac catherization laboratories services and support other entities that provide cardiac services to the surrounding community. Central Indiana Health System Cardiac Services, Inc. supports and encourages the activities and purposes of St. Vincent Hospital and Health Care Center, Inc. Schedule A, Part IV, Section E, Line 1b Activities That One Or More Supp. Org. Engaged In CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES, INC. OWNS A 74.08% INTEREST IN ST. VINCENT HEART CENTER OF INDIANA, LLC (SVHC), A LICENSED HOSPITAL. SVHC IS A SPECIALIZED CARDIOVASCULAR HOSPITAL SERVING HAMILTON AND CONTIGUOUS COUNTIES AND PROVIDES SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2739 2739 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. CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING 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. CENTRAL INDIANA HEALTH SYSTEM CARDIAC SERVICES, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 5345327 5345327 45163550 33241026 11922524 1793162 1679281 113881 16500815 11241448 5259367 729718 729718 23370817 INTEREST IN INVESTMENTS HELD BY ASCENSION HEALTH ALLIANCE 122126008 OTHER RECEIVABLES 924875 RECEIVABLES FROM THIRD PARTY PAYORS 189596 123240479 INTERCOMPANY PAYABLES 53457890 PAYABLES TO THIRD PARTY PROGRAMS 3327191 INTERCOMPANY DEBT TO ST. VINCENT HEALTH 24928077 81713158 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, 2016. true true X true X 250 true X true true true false true true 1519783 1519783 0.0312 9023367 3536509 5486858 0.1125 0 0.0 0 0 10543150 3536509 7006641 0.1437 5 1155 3412 3412 0.0001 2 131 49908 49908 0.0010 0 0.0 0 0.0 2 71 7803 7803 0.0002 9 1357 61123 0 61123 0.0013 9 1357 10604273 3536509 7067764 0.1449 0 0.0 0 0.0 1 800 1126 1126 0.0000 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 800 1126 0 1126 0.0000 false 119990 35997 67970152 69389271 -1419119 X true true 1 1 ST VINCENT HEART CENTER OF INDIANA LLC 10580 N MERIDIAN STREET INDIANAPOLIS IN 46290 http://www.stvincent.org 14-003284-1 X X ST VINCENT HEART CENTER OF INDIANA LLC 1 false false true X X X X X X X X X 15 true true false true X http://www.stvincent.org/how-we-are-different/community-assessment X true 15 true http://www.stvincent.org/how-we-are-different/community-assessment false false true X 250.0 400.0 X true true X X X true 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 HEART CENTER OF INDIANA, LLC. In conducting its CHNA, the hospital facility took into account input from representatives of the community as well as those with special knowledge or expertise in public health. These included Board of Directors for St. Vincent Fishers Hospital, Carmel Fire Department, Carmel Police Department, Central Indiana Community Foundation, Fishers Fire Department, Fishers United Methodist Church, Fishers YMCA, Good Samaritan Network of Hamilton, Inc., Hamilton County Health Department, Heart And Soul Clinic, Purdue Extension, Prevail, Inc., St. Vincent Fishers Hospital, Trinity Free Clinic, and United Way Central Indiana. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - St. Vincent Heart Center of Indiana, LLC. The hospital conducted its CHNA in conjunction with St. Vincent Carmel Hospital, St. Vincent Fishers Hospital, Community Health Network, Franciscan Health and Indiana University Health. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ST. VINCENT HEART CENTER OF INDIANA, LLC. Implementation Strategy Using the CHNA completed in fiscal year 2013, the hospital developed a 2014-2016 implementation strategy to address priority community health needs. These strategies include: 1. Obesity The Heart Center has created a Healthy Foods and Diet Program which works with the contract company, Touchpoint, to provide heart healthy options for visitors. The Retail Cafe has realized that adding healthy items is better than eliminating bad items at this time. There is now an educational table set-up to feature healthy items for the month including a farmer's market highlight in the summer. After the conclusion of FY2016, two Community Development & Health Improvement staff members conducted an observational field study to assess the implementation of action steps to transform menu offerings and provide nutrition education through the Retail Cafe. The following provides a snapshot of these action steps: Eliminate sugared beverages from menu: - Total number of available beverages=74 - Number of sugar-free/low sugar beverages=16 (22%) - Number of sugared beverages=58 (78%) Modify or discontinue menu items that do not meet heart-healthy guidelines: - Total number of food stations=6 - Number of food stations offering mainly heart-healthy items=2 (33%, salad bar and grill station) - Number of food stations with a majority of items that are not heart-healthy=4 (67%, two dessert bars, a deli-style sandwich station, and a fast food-style station) - Salad bar station is the first option that is made available. - Fit Bundle is a contest at the hospital that encourages people to buy a plate of healthy items. Post calorie/nutrition information for all menu items: The manager reports that the team is currently on a project to post calorie/nutrition information for all menu items, which was scheduled for completion in December, 2016. Implementation healthy cooking demonstrations during peak business hours (lunchtime): The Cafe hosts Welcome Wednesdays, a program led by the hospital's dietitian, and several community events at Market District to promote heart-healthy eating habits. SV Heart Center participated in several fairs including the Henry County Wellness Fair, Carmel Wellness Expo, and Black Expo Health Fair. Approximately 50 screenings were completed. Approximately, 100 participants received education. The Heart Center supports the American Heart Association in these events. The Go Red for Women event is a luncheon, over a 1,000 women receive healthy heart information. The Heart Ball is a more formal event to raise money for heart research. Finally, the Heart Walk gets thousands of people walking each year to support the American Heart Association. A new program called Men Go Red is also supported by the Heart Center. Administration provides their expertise on the American Heart Association board and two national committees. On these boards and committees, one of their goals is to educate legislators about heart disease. 2. Smoking Cessation Approximately, 100 participants received education. SV Heart Center now refers to the Tobacco Management Center at SV Indianapolis Hospital which has one-on-one and group meetings. SV Heart Center also ensures bedside hospital smoking cessation is offered to all patients. Administration participates in the Indiana Chapter of the American College of Cardiology and their efforts to educate legislators about the causes of heart disease. Administration participates in the American College of Cardiology professional association which this year educated legislators on access and obesity. 3. Stress Management SV Heart Center was unable to meet this strategy because the physician responsible for this health need retired. The St. Vincent FY 2017-2019 Implementation Strategy specifically addresses the following three System Wide Health Improvement Priorities: 1) Access to Health Services St Vincent Heart Center 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 Hamilton 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 Heart Center 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 the 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 Heart Center 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 the 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 the 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 the 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 priorities 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 Carmel supports the transportation service that is offered through PrimeLife Enrichment and has supported Partnership for a Healthy Hamilton County and other organizations that are focusing on this issue. Older Adults & Aging - This issue is being addressed in the Access to Health Services priority. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - St. Vincent Heart Center of Indiana, LLC. The discount was determined by reviewing the lowest discount provided to managed care payers that comprise at least 3% of our volume with an added prompt pay discount to the highest paid discount provided to our managed care payers. 0 Schedule H, Part I, Line 3c CRITERIA FOR DETERMINING ELIGIBILTY FOR FREE OR DISCOUNTED CARE The organization provides medically necessary care to all patients, regardless of race, color, creed, ethnic origin, gender, disability or economic status. The hospital uses a percentage of federal poverty level (FPL) to determine free and discounted care. At a minimum, patients with income less than or equal to 200% of the FPL, which may be adjusted for cost of living utilizing the local wage index compared to the national wage index, will be eligible for 100% charity care write off of charges for services that have been provided to them. Also, at a minimum, patients with incomes above 200% of the FPL but not exceeding 400% of the FPL, subject to adjustments for cost of living utilizing the local wage index compared to national wage index, will receive a discount on the services provided to them. Schedule H, Part I, Line 7 COMMUNITY BENEFIT OVERVIEW St. Vincent Carmel Hospital is part of St. Vincent, 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 is one of the largest healthcare employers in the state. As part of St. Vincent, the St. Vincent Carmel vision is to deliver a continuum of holistic, high-quality health services and improve the lives and health of Indiana individuals and communities, with special attention to the poor and vulnerable. This is accomplished through strong partnerships with businesses, community organizations, local, state and federal government, physicians, St. Vincent Carmel associates and others. Working with its partners, and utilizing the CHNA completed every three years, St. Vincent Carmel 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 Carmel, 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 Community Development & Health Improvement & Health Improvement Department, but associates at all levels of the organization contribute to community benefit and health improvement. Schedule H, Part I, Line 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST 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 Heart Center is committed to 100% access, and is proactive in providing healthcare that leaves no one behind. Public Program Participation St. Vincent Heart Center 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's conservative approach, Medicare shortfall is not included as community benefit. Community Health Needs Assessment True community benefit responds to the particular needs and challenges of the community, building on its unique strengths and assets. The hospital leads a community health needs assessment every 3 years. Using a variety of tools, including surveys, key person interviews, focus groups, secondary data, and data analysis professionals, the team identifies community issues and concerns. These are shared with the community at large, and a consensus is reached about priorities and available resources. To provide community input and a basis for collaboration within the community to address health needs, St. Vincent leads or participates in a community roundtable or forum. This group brings together individuals and organizations from throughout the community who share a common interest in improving health status and quality of life and provide expertise in a variety of community areas including public health. Obesity, smoking cessation, and stress management have all been identified as key community needs. Health Professions Clinical Training In an effort to prepare future healthcare professionals, St. Vincent Heart Center offers a variety of clinical settings and internships to undergraduate and vocational allied health professionals from University of Indianapolis, Purdue University, Marian University, IUPUI, Butler, Ivy Tech, and Ball State University. Health Fairs and Screenings St. Vincent Heart Center of Indiana, LLC participates in several health fairs and screenings throughout the year. Health information and preventive services material are a vital part of health fairs and screenings. Also, participants can be tested for blood pressure, cholesterol, pulmonary function, oxygenation and more at low or no cost. St. Vincent Heart Center participated in these health fairs in fiscal year 2016; Henry County Wellness Fair, Carmel Wellness Fair, and Black Expo Health Fair. CPR Class St. Vincent Heart Center, LLC provided a health educational class on CPR. This class is to teach individuals how to properly perform the lifesaving technique. To get certified in CPR, individuals will learn the correct method of compressions, clearing the airway and how to perform appropriate breathing techniques. Community Benefit Cash and In-Kind Contributions In addition to the outreach programs operated by the hospital, the hospital makes cash and in-kind donations to a variety of community organizations focused on improving health status in the community. These take the form of cash donations to outside organizations, the donation of employee time/services to outside organizations and the representation of the hospital on community boards and committees working to improve health status and quality of life within the community. Schedule H, Part II COMMUNITY BUILDING ACTIVITIES Research shows that social determinants and quality of life play a major role in the health status of individuals and communities. Community building activities, which focus on improving the quality of life within a community, ultimately influence and improve health status. Community Building Cash and In-Kind Contribution The hospital makes cash and in-kind donations to a variety of community organizations focused on building the community and improving quality of life. These take the form of cash donations to outside organizations, the donation of employee time/services to outside organizations and the representation of the hospital on community boards and committees working to improve infrastructure for the community. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2016 was $515,586 at charges, ($119,990 at cost). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 18. 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 Communities are dynamic systems in which multiple factors interact to impact quality of life and health status. In addition to the formal CHNA conducted every 3 years, St. Vincent Heart Center of Indiana helps to lead a community roundtable called Partnership for a Healthy Hamilton County whose purpose is to assess needs within the community, prioritize action and work in partnership to address identified challenges. The coalition works closely with its member organizations which come from multiple sectors of the community, including local government, business, education, faith communities, public health, health care providers and other social and human service organizations. In addition, the coalition works closely with other coalitions as well as the local and state health departments to stay abreast of changing needs within the community and to identify evidence-based and promising practices to address these needs. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance St. Vincent Heart Center of Indiana, LLC 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 The St. Vincent Heart Center of Indiana, LLC (SVHC) is located in the southern portion of Hamilton County, which borders Marion County, home to Indianapolis. SVHC serves mostly Central Indiana; however, its reach extends to the entire state and beyond. St. Vincent Heart Center of Indiana, LLC is located in Carmel, Indiana. Hamilton County has an estimated population of 309,697. Per capita personal income and median household income are above state averages. The poverty rate for Hamilton County is 4.9. The majority race is white which makes up 87.8% of the population, followed by Asians at 5.9%. Hispanics comprise 3.9% of the population. Median age for the county is 36.6 years. Schedule H, Part VI, Line 5 Promotion of community health St. Vincent Heart Center of Indiana, LLC promotes the health of its communities by striving to improve the quality of life within the community. Research has established that factors such as economic status, employment, housing, education level, and built environment can all be powerful social determinants of health. Additionally, helping to create greater capacity within the community to address a broad range of quality of life issues also impacts health. St. Vincent Heart Center of Indiana, LLC meets regularly with local organizations in the community to learn what resources are available and plan community health improvement efforts. In fiscal year 2016, these organizations included: Good Samaritan Network, Community Hospital, IU Health, St. Francis Hospital, YMCA, Aspire Riverview Health, and staff from Partnership for a Healthy Hamilton County. Schedule H, Part VI, Line 6 Affiliated health care system As part of St. Vincent, St. Vincent Heart Center of Indiana, LLC is dedicated to improving the health status and quality of life for the communities it serves. While designated associates at St. Vincent Heart Center of Indiana, LLC devote all or a significant portion of their 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 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 in which St. Vincent Heart Center of Indiana, LLC participates. true true false false false false false false false JULIE M CARMICHAEL FORMER OFFICER 0 175777 0 108369 0 145313 0 4990 0 11417 0 445866 0 0 IAN G WORDEN FORMER OFFICER 0 0 0 0 0 289650 0 0 0 1004 0 290654 0 0 MICHAEL L MULLINS SYSTEM VP-MINISTRY OPERATING EXEC 0 499876 0 169205 0 5384 0 13250 0 29340 0 717055 0 0 JONATHAN NALLI CHAIR - SYSTEM CEO 0 852923 0 484151 0 114078 0 13250 0 36774 0 1501176 0 0 BLAKE A DYE PRESIDENT-SVHCI 498021 0 195554 0 115227 0 14575 0 25796 0 849173 0 0 0 MICHAEL K SCHROYER COO - SVHCI 219206 8768 61369 0 938 38 11576 200 29422 1177 322511 10183 0 0 BECKY L JACOBSON VP FINANCE - SVHCI 185928 0 45927 0 256 0 14230 0 18730 0 265071 0 0 0 JOSEPH B LANDIS TEAM LEAD CATH - SVHCI 178204 0 3531 0 4399 0 11968 0 16871 0 214973 0 0 0 ALEX W LEE DIRECTOR - PHARMACY 126219 0 13055 0 193 0 4458 0 29444 0 173369 0 0 0 KAREN B RICHMOND OR NURSE - SVHCI 124255 0 12293 0 405 0 4199 0 17588 0 158740 0 0 0 JEFFERY L BOARDS RN - CARDIOVASCULAR 151038 0 2383 0 184 0 4675 0 17649 0 175929 0 0 0 LORI L SHANNON CARDIOVASCULAR RN - SVHCI 186387 0 44932 0 379 0 11317 0 2006 0 245021 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 Central Indiana Health System Cardiac Services, 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 4a Severance or change-of-control payment The following individuals received severence payments from the organization or a related organization during the calendar year 2015: Julie M Carmichael - $142,919 Ian G Worden - $289,650 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. Form 990, Part IV, Line 24a Part IV, Line 24a Tax Exempt Bond Issuance Central Indiana Health System Cardiac Services, Inc. is a holding company that is part of Ascension Health System. Ascension Health is the borrower for tax exempt hospital revenue bonds. Central Indiana Health System Cardiac Services, Inc. holds an intercompany note payable with Ascension Health, and this information is reported on the balance sheet. Form 990, Part VI, Line 6 Classes of members or stockholders Central Indiana Health System Cardiac Services, Inc. has a single corporate member, St. Vincent Health, Inc. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Central Indiana Health System Cardiac Services, Inc. has a single corporate member, St. Vincent Health, Inc. who has the ability to elect members to the governing body of Central Indiana Health System Cardiac Services, Inc. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Central Indiana Health System Cardiac Services, 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 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form 990 to a designated committee of the Board to review and answer any questions. Prior to filing the returns, all Board members are provided the Form 990 and management team members are available to answer any Board member questions. 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 committee 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 15b Process to establish compensation of other employees Compensation determinations of Central Indiana Health System Cardiac Services, Inc.'s CEO, executive director, or top management official is made by Ascension Health's management. The process includes a review and approval by independent persons and comparability data. In review of the compensation, the CEO, executive director, and top management were compared to other hospitals in the area that hold the same position. Compensation determinations of Central Indiana Health System Cardiac Services, Inc.'s other officers or key employees are made by Central Indiana Health System Cardiac Services, Inc.'s management. In determining compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review of the compensation, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same position. Form 990, Part VI, Line 19 Required documents available to the public The organization will provide any documents open to public inspection upon request. 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